Healthcare Provider Details

I. General information

NPI: 1164661856
Provider Name (Legal Business Name): RYAN HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58945 BUSINESS CENER DRIVE SUITE D
YUCCA VALLEY CA
92284
US

IV. Provider business mailing address

7091 MECCA RD
JOSHUA TREE CA
92252-2779
US

V. Phone/Fax

Practice location:
  • Phone: 760-228-9657
  • Fax:
Mailing address:
  • Phone: 760-366-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: